Pyati Anand K, Khanikekar Pradeep K, Shetkar Nagaraj R, Patil Mallanagouda M, Jaju Purushottam B, Karra Madhu Latha, Pyati Sudharani A, Shannawaz Mohd
Biochemistry, All India Institute of Medical Sciences, Bibinagar, Hyderabad, IND.
Family Medicine, Indian Army Military Hospital, Secunderabad, IND.
Cureus. 2022 Jun 20;14(6):e26115. doi: 10.7759/cureus.26115. eCollection 2022 Jun.
Context Neonatal birth/perinatal asphyxia is a serious condition with the potential to cause damage to various tissues of the body especially the brain. Hypoxia can cause metabolic disturbances, which in turn can lead to imbalances in the levels of glucose, electrolytes, and calcium, which can further worsen the condition. Early detection of these biochemical derangements and immediate correction can prevent the complications and lifelong disabilities of birth asphyxia due to injury to vital organs particularly the brain. The aim is to assess any correlation between the cord blood glucose, electrolytes, and calcium levels and the severity of birth asphyxia. Methods and material In this study, 50 birth asphyxia neonates with birth weight >2.5 kg, and a 5-minute Apgar score ≤ 6 at birth with clinical evidence of asphyxia were compared with healthy neonates with birth weight > 2.5 kg, and a 5-minute Apgar score > 7. In all the cases and controls, cord blood glucose was estimated by glucose oxidase and peroxidase (GOD-POD) method, total calcium by Arsenazo method, and sodium and potassium were estimated by ion-selective Electrode (ISE) method using fully automated biochemistry analyzers. Results The mean cord blood concentrations of glucose, sodium, potassium, and calcium were significantly lower among birth asphyxia neonates in comparison with that of controls (p < 0.05). The correlation coefficient (r) for the study variables among cases indicates that there is a low to moderate positive correlation between the 5-minute Apgar score which is a measure of severity of birth asphyxia and cord blood concentrations of glucose, sodium, and calcium. Conclusion In our study, birth asphyxiated neonates were found to have statistically significant low levels of cord blood glucose and electrolytes like sodium and calcium except for potassium. There was a low to moderate positive correlation between cord blood glucose and electrolyte concentrations with the severity of birth asphyxia. Analysis of cord blood for these simple biochemical tests can help pediatricians in the active management of birth asphyxia cases.
新生儿出生时/围产期窒息是一种严重疾病,有可能对身体的各种组织尤其是大脑造成损害。缺氧可导致代谢紊乱,进而导致葡萄糖、电解质和钙水平失衡,这会使病情进一步恶化。早期检测这些生化紊乱并立即纠正,可预防因重要器官尤其是大脑受损导致的出生窒息并发症和终身残疾。目的是评估脐血葡萄糖、电解质和钙水平与出生窒息严重程度之间的相关性。
在本研究中,将50例出生体重>2.5 kg、出生时5分钟阿氏评分≤6且有窒息临床证据的出生窒息新生儿与50例出生体重>2.5 kg、出生时5分钟阿氏评分>7的健康新生儿进行比较。在所有病例和对照中,使用全自动生化分析仪,采用葡萄糖氧化酶和过氧化物酶(GOD-POD)法测定脐血葡萄糖,采用偶氮胂法测定总钙,采用离子选择性电极(ISE)法测定钠和钾。
与对照组相比,出生窒息新生儿脐血葡萄糖、钠、钾和钙的平均浓度显著降低(p<0.05)。病例组研究变量的相关系数(r)表明,作为出生窒息严重程度指标的5分钟阿氏评分与脐血葡萄糖、钠和钙浓度之间存在低到中度的正相关。
在我们的研究中,发现出生窒息新生儿除钾外,脐血葡萄糖和钠、钙等电解质水平在统计学上显著降低。脐血葡萄糖和电解质浓度与出生窒息严重程度之间存在低到中度的正相关。对脐血进行这些简单的生化检测分析有助于儿科医生积极处理出生窒息病例。